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Balloon pulmonary angioplasty of right pulmonary artery pouch occlusion. A small fenestration emanating from the baseline interlobar pouch occlusion (a) is crossed using a workhorse wire and dilated using a 2-mm-diameter balloon (b). Serial dilatation using noncompliant balloons up to a 5-mm diameter (c) restores perfusion to branches of the A9 and A10 lower lobe segments (d). The patient was ineligible for pulmonary endarterectomy due to numerous prohibitive surgical comorbidities.
